Early risk factors and six month posttraumatic stress disorder symptom severity following trauma.

Background

Posttraumatic stress disorder (PTSD) is a significant public health concern associated with persistent psychological impairment following trauma exposure. Early identification of risk factors is critical for timely intervention and prevention of chronic symptoms.

Objective

This study examined early post-trauma cognitive, emotional, trauma-related, and socioeconomic factors associated with PTSD symptom severity at six-month follow-up, with sleep quality and self-perceived pain as potential mediators.Method: A total of 178 adults were recruited from an emergency department and assessed approximately two weeks following trauma exposure. Partial least squares structural equation modeling (PLS-SEM) was used to evaluate cognitive attributions, trauma history, emotion responding and regulation, and socioeconomic factors as predictors of six-month PTSD symptom severity. PTSD symptom severity at two weeks post-trauma was included as a covariate to account for early symptom levels.

Results

Maladaptive cognitive attributions demonstrated strong direct associations with later PTSD symptom severity and significant indirect associations through sleep quality and self-perceived pain. Trauma history showed a modest association with PTSD symptoms. Emotion responding and regulation was indirectly associated with PTSD symptom severity through sleep quality, suggesting a sleep-mediated pathway. Socioeconomic factors were not significantly associated with PTSD symptom severity. These effects were observed after accounting for PTSD symptom severity at two weeks post-trauma.

Conclusions

Early maladaptive cognitive attributions and sleep disturbances represent key clinical targets for early post-trauma intervention. Addressing these factors promptly after trauma may help reduce the risk of chronic PTSD.